Clinical and Physiologic Study of Encopresis.
- Author:
Soon Sup CHUNG
1
;
Jae Bong KWON
Author Information
1. Department of Surgery, College of Medicine, Kon-kuk University, Chung Ju, Korea.
- Publication Type:Original Article
- Keywords:
Encopresis;
Anal manometry;
Defecography;
Constipation;
Biofeedback treatment
- MeSH:
Anal Canal;
Ataxia;
Barium;
Biofeedback, Psychology;
Child;
Constipation;
Defecography;
Encopresis*;
Follow-Up Studies;
Humans;
Manometry;
Pelvic Floor;
Retrospective Studies
- From:Journal of the Korean Society of Coloproctology
2000;16(3):171-176
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The pathophysiology of pediatric encopresis has been incomprehensible. The current study was designed to assess its clinical and physiologic findings. Moreover, outcome of treatment was evaluated. METHODS: The clinical and functional findings of 18 patients (13 boys, 5 girls) were analyzed, retrospectively. Physiologic studies for cooperative child included anal manometry (n=12), cinedefecography (n=3), and PNTML (pudendal nerve terminal motor latency, n=1). For exclusion of the organic cause, barium contrast study was carried out in all case. Patients were categorized by leading symptom as constipation or incontinence. Physiologic findings and outcome of treatment were analyzed based on the categorized groups. Biofeedback therapy by using newly-developed anal sphincter control system (KONTINENCE CLINICAL(TM)) in my institute, was underwent a mean 4.1 (range, 2~12) sessions. The outcome was analyzed in the period of 5.4 (range, 1~33) months follow-up. RESULTS: Patients were categorized as having constipation (group I, n=12) or incontinence (group II, n=6) group. In the manometric parameters, there were no statistical differences between the values of the mean resting pressure (RP), the maximum RP, and the maximum voluntary contraction between group I and II. In the cinedefecography, 3 of group I patients revealed as having the pelvic floor dyssynergia. The findings of PNTML were not specific in group II (n=1). Regarding to the therapeutic outcome, 8 of 10 patients were cured or improved. CONCLUSIONS: There were no differences in the resting and squeeze profiles of manometric parameters between two groups. However, pelvic floor dyssynergia was identified in the cinedefecography of constipated group. Conventional and biofeedback treatment for encopretic children provides acceptable outcome.
